背景:颞叶癫痫(TLE)患者在静息状态下海马功能的横向改变已得到证实。然而,海马的静息状态fMRI尚未被证实为标准的癫痫发作病灶术前评估的辅助手段.
目的:在这里,我们报告了一项关于TLE患者海马网络连通性偏侧性的静息状态fMRI研究的系统评价结果。
方法:对PubMed的搜索,Scopus,WebofScience,和Embase数据库以英语撰写的全长文章使用以下术语进行到2020年6月:“静息状态功能磁共振成像,\'\'海马体,\'\'癫痫,\'和\'横向。
结果:我们的文献检索共产生42篇论文。在排除不包括癫痫患者的研究后,利用静息状态功能磁共振成像,或者探索功能连通性和疾病侧化之间的关系,选择了20种出版物。从这些研究中,共528名患者,带有左TLE的258和带有右TLE的270,纳入447名健康对照.在包括的20项研究中,18发现TLE患者与癫痫灶同侧的海马功能连通性降低,另外10例报告与癫痫灶对侧的海马功能连通性增加。一些研究表明,疾病的持续时间与功能连接的这些变化相关。这意味着治疗难治性TLE患者可能存在代偿机制。
结论:在多项研究中这种海马连接模式的一致性表明,静息状态功能磁共振成像可能是一种用于TLE患者术前评估的非侵入性诊断工具。
BACKGROUND: Lateralized alterations in hippocampal function in the resting-state have been demonstrated for patients with temporal lobe epilepsy (TLE). However, resting-state fMRI of the hippocampus has yet to be substantiated as an adjunct to standard pre-operative assessments of the seizure focus.
OBJECTIVE: Here we report the results of a systematic
review of resting-state fMRI studies investigating laterality of hippocampal network connectivity in TLE patients.
METHODS: A search of the PubMed, SCOPUS, Web of Science, and Embase databases for full-length articles written in English was conducted through June 2020 using the following terms: \'resting state fMRI,\' \'hippocampus,\' \'epilepsy,\' and \'laterality.\'
RESULTS: Our literature search yielded a total of 42 papers. After excluding studies that did not include patients with epilepsy, utilize resting-state fMRI, or explore the relationship between functional connectivity and disease lateralization, 20 publications were selected for inclusion. From these studies, a total of 528 patients, 258 with left TLE and 270 with right TLE, and 447 healthy controls were included. Of the 20 studies included, 18 found that patients with TLE demonstrated decreased hippocampal functional connectivity ipsilateral to the epileptogenic focus and 10 additionally reported increased hippocampal functional connectivity contralateral to the epileptogenic focus. Several studies demonstrated that the duration of disease was correlated with these changes in functional connectivity. This implies that a compensatory mechanism may be present in patients with treatment-refractory TLE.
CONCLUSIONS: The consistency of this hippocampal connectivity pattern across multiple studies suggests resting-state fMRI may be useful as a non-invasive diagnostic tool for preoperative evaluation of TLE patients.